Chippaux J , 2017. Snakebite envenomation turns again into a neglected tropical disease! J Venom Anim Toxins Incl Trop Dis 23: 38. doi: 10.1186/s40409-017-0127-6.
Gutiérrez J , Calvete J , Habib A , Harrison R , Williams D , Warrell D , 2017. Snakebite envenoming. Nat Rev Dis Primers 3: 17079. doi: 10.1038/nrdp.2017.63.
Wagener M , Naidoo M , Aldous C , 2017. Wound infection secondary to snakebite. South Afr Med J 107: 315–319.
Mao Y , Liu P , Hung D , Lai W , Huang S , Hung Y , Yang C , 2016. Bacteriology of Naja atra snakebite wound and its implications for antibiotic therapy. Am J Trop Med Hyg 94: 1129–1135.
Yeh H , Gao S , Lin C , 2021. Naja atra wound infections from Taiwan cobra bites: determining bacteriology, antibiotic susceptibility, and the use of antibiotics: a cobra bite study. Toxins (Basel) 13: 183. doi: 10.3390/toxins13030183.
Goldstein E , Citron D , Gonzalez H , Russell F , Finegold S , 1979. Bacteriology of rattlesnake venom and implications for therapy. J Infect Dis 140: 818–821.
Nishioka SA , Silveira P , 1992. Bacteriology of abscesses complicating bites of lance-headed vipers. Ann Trop Med Parasitol 86: 89–91.
Lipsky B et al.2012. 2012 Infectious Diseases Society of America clinical practice guideline for the diagnosis and treatment of diabetic foot infections. Nephrol Dial Transplant 54: e132–e173.
Li W , Chen F , Wu S , 2016. The related risk factors analysis of snake-bite induced acute kidney injury. Med Sci Monit 22: 2335–2339.
Chen X , He H , Cai H , 2019. Clinical and epidemiologic profile of venomous snakebites in Chongqing Wuling mountainous area, western China. Trans R Soc Trop Med Hyg 113: 587–589.
Liu C , Lin C , Hsiao Y , Wang P , Yu J , 2018. Proteomic characterization of six Taiwanese snake venoms: identification of species-specific proteins and development of a SISCAPA-MRM assay for cobra venom factors. J Proteomics 187: 59–68.
Su H , Huang S , Mao Y , Liu M , Lee K , Lai P , Tsai M , 2018. Deinagkistrodon acutus clinical and laboratory features distinguishing between and envenomation. J Venom Anim Toxins Incl Trop Dis 24: 43. doi: 10.1186/s40409-018-0179-2.
Chen P , Huang M , Chang J , Liu C , Chen C , Hsieh C , 2019. Snake venom proteome and immuno-profiling of the hundred-pace viper, Deinagkistrodon acutus, in Taiwan. Acta Trop 189: 137–144.
Huang F , Zhao S , Tong F , Liang Y , Le Grange J , Kuang W , Zhou Y , 2021. Unexpected death in a young man associated with a unilateral swollen leg: pathological and toxicological findings in a fatal snakebite from Deinagkistrodon acutus (Chinese moccasin). J Forensic Sci 66: 786–792.
Lin C , Chen Y , Goh Z , Seak C , Seak J , Shi-Ying G , Seak C , Spot Investigators , 2020. Wound infections of snakebites from the venomous protobothrops mucrosquamatus and viridovipera stejnegeri in Taiwan: bacteriology, antibiotic susceptibility, and predicting the need for antibiotics—a BITE study. Toxins (Basel) 12: 575. doi: 10.3390/toxins12090575.
Garg A , Sujatha S , Garg J , Acharya N , Chandra Parija S , 2009. Wound infections secondary to snakebite. J Infect Dev Countries 3: 221–223.
Kerrigan K , 1992. Bacteriology of snakebite abscess. Trop Doct 22: 158–160.
Abrahamian F , Goldstein E , 2011. Microbiology of animal bite wound infections. Clin Microbiol Rev 24: 231–246.
Blaylock RS , 1999. Antibiotic use and infection in snakebite victims. South Afr Med J 89: 874–876.
Theakston RD , Phillips RE , Looareesuwan S , Echeverria P , Makin T , Warrell DA , 1990. Bacteriological studies of the venom and mouth cavities of wild Malayan pit vipers (Calloselasma rhodostoma) in southern Thailand. Trans R Soc Trop Med Hyg 84: 875–879.
Arroyo O , Bolaños R , Muñoz G , 1980. The bacterial flora of venoms and mouth cavities of Costa Rican snakes. Bull Pan Am Health Organ 14: 280–285.
Ledbetter EO , Kutscher AE , 1969. The aerobic and anaerobic flora of rattlesnake fangs and venom: therapeutic implications. Arch Environ Health 19: 770–778.
Lam KK et al.2011. A cross-sectional survey of snake oral bacterial flora from Hong Kong, SAR, China. Emerg Med J 28: 107–114.
Hoogerheide JC , 1937. Variability in morphological and biochemical properties of Clostridium histolyticum (Weinberg and Seguin). J Bacteriol 34: 387–407.
Jorge M , Ribeiro L , da Silva M , Kusano E , de Mendonça J , 1994. Microbiological studies of abscesses complicating Bothrops snakebite in humans: a prospective study. Toxicon 32: 743–748.
Murray J , Connell J , Stacy A , Turner K , Whiteley M , 2014. Mechanisms of synergy in polymicrobial infections. J Microbiol 52: 188–199.
Palappallil D , 2015. Pattern of use of antibiotics following snake bite in a tertiary care hospital. J Clin Diagn Res 9: OC05–OC09.
Padhi L , Panda S , Mohapatra P , Sahoo G , 2020. Antibiotic susceptibility of cultivable aerobic microbiota from the oral cavity of Echis carinatus from Odisha (India). Microb Pathog 143: 104121. doi: 10.1016/j.micpath.2020.104121.
|Past two years||Past Year||Past 30 Days|
|Full Text Views||70||70||22|
Snakebite is a common occurrence in Hangzhou, and identifying bacteria in wounds is very important for snakebite treatment. To define the pattern of wound bacterial flora of venomous snakebites and their susceptibility to common antibiotics, we reviewed the medical charts of patients admitted with snakebite at Hangzhou TCM Hospital from January 2019 to December 2020. A total of 311 patients were enrolled in this study. Among them, bacteria culture was positive in 40 patients, and 80 organisms were isolated. The most frequent pathogens were Morganella morganii and Staphylococcus aureus. According to the results of susceptibility testing, a majority of the isolates were resistant to some common first-line antibiotics, such as ampicillin, ampicillin/sulbactam, amoxicillin/clavulanic acid, cefoxitin, and cephazolin. Quinolones, however, have shown a better antibacterial effect. In conclusion, snakebite wounds involve a wide range of bacteria. Fluoroquinolones, such as levofloxacin and ciprofloxacin, could be an alternative for empirical treatment in patients with snakebite when the effect of other antibiotics is poor.
Disclaimer: The study project was allowed by The Institutional Ethics Committee, Hangzhou TCM Hospital, affiliated with the Zhejiang Chinese Medical University, and all research work complied with the Helsinki Declaration.
Authors’ addresses: Sipin Hu, Department of Vascular Surgery, Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang, People’s Republic of China, E-mail: email@example.com. Zhengqing Lou and Mengyun Tu, Department of Clinical Laboratory, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China, E-mails: firstname.lastname@example.org and email@example.com. Yuchen Shen, Department of Dermatology, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China, E-mail: firstname.lastname@example.org.